One of my complaints about 3.5E D&D is about “Save or Die” effects. A save or die effect is any magical abilitiy (such as flesh to stone, finger of death, hold person, etc.) that incapacitates the target if it fails its saving throw. These effects may “realistically” model the dangers of fighting high level characters, but in practice they are simply not fun. Losing control of your character for a number of rounds in combat is the worst thing that can happen to a player.

Fourth edition is promising a removal of save or die effects (or at least, a massive reform), and I look forward to that. However, 4E is not out yet and a lot of us are still running 3.5E campaigns. Here I present some modifications for you as a DM to use on the abilities of your NPCs, monsters, traps, and so on. (I do not see the need for or recommend applying the modifications to players, as it’s perfectly fun for an NPC to be wiped out with a word. Go ahead though if you really feel the symmetry is necessary.)

I give other characters options to help a disabled character because it’s always more fun in a game when you can use your skills to help others. Instead of avenging the fallen wizard, the ranger can now use their high Heal skill (a skill that sees little use) in a heroic attempt to bring their comrade back from the brink of death. The save or die effect was still effective: the target character is most probably removed from combat for at least 2, if not 3 rounds. Another character will probably have to spend 1 to 2 rounds to save their friend, something that would not have happened if the target simply died. WotC tells us most combats last 5 rounds. This means the successful death effect, even if it fails to kill a player, consumes 4-5 combined player rounds which is the same as one character’s worth of actions over the entire combat. The flow of the fight shifts and changes as tanks must now defend a vulnerable healer as they spend their actions tending to the fallen, and I think this lead to a more interesting game all around.

Instant Death Effects
There are a lot of instant death effects in the game: finger of death, wail of the banshee, power word: kill, circle of death, destruction, slay living, symbol of death, etc. (and these are just core book spells, many more are added in splatbooks and campaign enhancements like The Book of Vile Darkness).
Modifcation: Instead of the target being outright slain on a failed save, they drop to 0 hp and are considered nauseated in addition to disabled. Flavor text like this would be appropriate:
You feel icy fingers grip your heart and it begins to spasm, skipping beats. Sharp pain radiates out from your chest as your muscles cramp, your stomach turns to water and you struggle to breathe.
On the next round, the afflicted character drops to -1 hit points and is dying. On the third round, they die.
Saving the Character
A character spending a full round tending the afflicted can make a heal check. If the heal check is higher than the DC of the death effect, the afflicted stabilizes at 0 hit points, conscious but disabled. The character tending the fallen may keep attempting heal checks until the fallen character dies.
Every round the afflicted character receives a new magical healing effect (healing potion, cure, etc) they do not worsen. They must receive a new effect each round to keep from slipping unconscious and dying.
Alternatively, a heal, greater restoration, wish, or miracle removes the death effect and the character stabilizes at 0 hit points, conscious but disabled.


The dark elven wizard mutters a few arcane words, and the spell settles onto you like a mountain, gripping tightly. You feel as though you are encased in mud as you fight the enchantment burrowing into you. Your skin begins to harden, freezing in rough furrows and cracking as you struggle to move.
On the first round after failing a save versus a petrification effect, the afflicted character is affected as if by a slow spell. They can only take a single move or standard action (but not both). The character suffers a -1 penalty to attack rolls, AC, and Reflex saves. The character moves at half its normal speed.
On the second round, the petrification becomes obvious to all. The character’s skin looks more like stone than flesh and rock dust is given off by every move. The character may only take a single move equivalent action. However, they gain damage reduction 8/adamantine.
On the third round the transformation is complete. The character is now a stone object.
Every round after the first the character gets a new saving throw versus the effect. If the save is successful, the transformation reverses by one stage (removing the effect completely if saved at the first stage). This allows friendly casters to aid the character with a resistance, protection from X, etc.


Compulsion Effects
Compulsion effects include the charms, dominates, and suggestion. When an ally is affected by a compulsion effect, you may spend a standard action to make an Intimidate or Diplomacy check. If your check beats the DC of the compulsion effect, the afflicted character takes no action that round. This has no effect on the duration of the compulsion effect, or what the afflicted character may do on subsequent rounds.


Hold Person
I don’t like hold person very much. It does allow casters to effectively target a creature’s Will save, but it does so far more effectively than other, similar spells and is just plain boring. “Well, I can’t do anything for the rest of the fight.” It has no flavor or secondary effect, it’s the most vanilla spell I can think of along with magic missile.
As a DM I’ve worked to find other alternatives for NPC spell casters to use. Good alternatives include creative uses of suggestion that don’t involve removing a character from the entire fight, deep slumber because it allows actions to “save” a character from its effects, crushing despair, confusion (because at least the effects are varied and allow some chance of acting normally), and blindness because the character still gets actions.

Many save or die effects remain in the game (fears, high level instant death effects such as implosion), but the high level game tends to be inherently more volatile anyway. Hopefully these ideas will make the low and mid levels more fun, and breathe new life into the Heal skill.